| Caroline Knight

Vulvar Pain: How Do You Diagnose Vulvodynia?

 

Vulvodynia is the vulvar pain condition characterized by feelings of chronic pain and discomfort in the vulvar, introitus or hymenal areas. Pain can manifest mildly or severely and it can vary in intensity at different times. To diagnose vulvodynia it is necessary to move through a process of different assessments and tests. The condition is notoriously difficult to diagnose, so some patience may be required.

 

Many vulvodynia sufferers experience tenderness after any degree of pressure, even from something as gentle as a cotton swab. Understandably, pressure from activities like exercise or sexual intercourse are likely to aggravate the condition considerably. If you wish to diagnose vulvodynia, you will need to be prepared for an examination of your personal history be sure that your pain is not rooted in any potential infectious or dermatologic causes.

 

How your practitioner will diagnose vulvodynia

 

When your healthcare practitioner is trying to diagnose vulvodynia, they will assess your medical history carefully, as well as your sexual and surgical history. Once all other pain-causing abnormalities are ruled out, it may be possible to pinpoint nerve damage or misinterpretations of pressure by the nervous system, which are the most probable causes of vulvodynia.

 

They are likely to look at aspects such as:

 

  • Pain characteristics
  • Related bowel, bladder, and sexual issues
  • Blood results to determine hormone levels (estrogen, progesterone and testosterone)

 

At an appointment to diagnose vulvodynia, you will be asked to take part in a cotton swab test. This involves exertion of light pressure via indention of around 5mm with a swab, which is likely to cause some degree of pain if you do have vulvodynia.  This pressure will be applied to various areas of your vulva, while your pain response is measured through your verbal feedback. Your practitioner may ask you to rate the pain sensations on a scale.

 

Vulvodynia sufferers are likely to experience the most sensitivity in the following areas:  

 

 

It is possible for you to feel spontaneous pain even without pressure from a swab. It is also likely that you will experience sensitivity in any or all of these areas if you have provoked vulvodynia.


Other things to note about diagnosing vulvodynia

 

To diagnose vulvodynia your Doctor may also perform a pelvic exam, which consists of visually examining your external genital region to pinpoint symptoms and causes. Although there may not be visible signs, a cell sample may be taken to rule out infections. Similarly, if your healthcare provider finds any cause for concern in the form of unusual skin appearance, they may wish take a tissue sample for lab analysis.

 

At the very least they are likely to carefully examine the area with a magnifying device. Redness and rashes in the vulvar area generally do not indicate vulvodynia, although it is possible that such symptoms could also be present. In this instance, a biopsy may be necessary.

 

First and foremost, diagnosing vulvodynia is a process of elimination. It may not be possible to diagnose vulvodynia instantly, so it helps to accept that you may need to attend follow up appointments or wait a while for test results to come back. However, with patience and persistence you should be able to diagnose vulvodynia - if it really is the cause of your pain. If so, know that there are many vulvodynia treatments available to you, but finding the right ones for you could also be a process of trial and error. We wish you the best of luck in getting your diagnosis!